Skin Speak by Svetlana Kogan, M.D.

Observe and pay attention

As a Functional Medical Doctor, I have always been fascinated with the way the human body presents us with the clues to the underlying health issues. The art of conducting a detailed medical exam is long lost to the current state of mainstream medical exams. And when was the last time you had to undress in your primary care doctor’s office to be examined by your doctor anyway?

Nevertheless, the body communicates with us subtly not just by the way it makes us feel but also by manifesting certain patterns on the skin surface, for you to notice and take action. In the next series of articles, I will tell you about the common physical presentations which could herald underlying disorders. An educated patient is an empowered patient and hopefully this information will help you and your family and friends to be preventive about your health.

A lot can be said about the temperature of the skin. If it is very low, it may be prudent to check a person for dehydration or underactive thyroid (hypothyroidism).

Small itchy blisters on elbows, knees, or lower back – could be the sign of dermatitis herpetiformis – a skin disorder often associated with deficiencies in such micronutrients as zinc, selenium, magnesium, B12, folate or iron. It is also commonly associated with gluten sensitivity or celiac disease.

If the skin looks like toad skin, with areas of roughness over the posterior or lateral arms and extensor surfaces of the limbs, you could be looking at Follicular Hyperkeratosis – a skin condition which could signify a serious deficiency in vitamin A or essential fatty acids such as Omega-3 fatty acids. If the skin looks much darker in the creases of the neck, armpits and elbows – you might be looking at Acanthosis nigricans – which often heralds an underlying endocrine illness, from insulin resistance or overt diabetes to thyroid disease and many other hormonal issues.

Skin scales isolated to the area around the nasal nares could be the sign of seborrheic dermatitis caused by B-vitamin deficiencies or the presence of candida, a type of yeast in the body.

Thin and translucent skin with cellophane appearance in the elderly folks can be a sign of protein deficiency. Mysterious spontaneously appearing larger bruises or smaller hemorrhages on the body can be a sign of Vitamin C or Vitamin K deficiency.

Grey-tan or bronze looking skin can be a valuable clue to excessive iron disease (hemochromatosis) a life-threatening condition which is easily treatable when diagnosed early.

Little orange yellow nodules on the inner third of the upper or lower eyelids could mean that a person has abnormal triglycerides or another hyperlipidemia.

Every skin finding can be looked at through Functional Medicine lens: looking for unique life events that could have triggered a clinical imbalance. For example, if I am looking at acne, I always make note of inadequate sleep, high stress, or excessive dairy and processed sugars consumption, or the frequent use of antibiotics which may have thrown off the microbiome balance of the patient’s gut.

Please note that any of the above-mentioned skin presentations could turn out to be nothing – just the way a person looks – but they are certainly worth checking out starting with your PCP and possibly with the dermatologist as well.

The author of ‘Diet Slave No More!’, Svetlana Kogan, MD is a Board-Certified Internal Medicine, Holistic & Functional Medical Doctor with 25 years of experience. Her website is Office phone: 239-676-6883

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